摘要
目的探讨腹主动脉瘤(AAA)腔内修复术(EVAR)中封闭髂内动脉对患者术后发生盆腔缺血性并发症的影响。方法采用回顾性病例对照研究方法,分析2018年1月—2023年10月内蒙古自治区人民医院收治的177例接受EVAR封闭髂内动脉治疗的肾下型AAA患者的临床资料。按照术中髂内动脉的封闭情况分为A、B、C组。A组(n=20)患者EVAR术中封闭双侧髂内动脉,B组(n=75)患者EVAR术中封闭单侧髂内动脉,C组(n=82)患者EVAR术中保留双侧髂内动脉。分别记录并比较3组患者在术后及随访期间盆腔缺血性并发症发生情况。计量资料以均数±标准差(±s)表示,3组之间比较采用方差分析;计数资料组间比较采用χ^(2)检验及其连续校正法。结果3组患者的年龄、性别、瘤体最大径、吸烟、饮酒及合并症(高血压、糖尿病、冠心病、脑梗死等)方面比较,差异均无统计学意义(P>0.05)。A组和B、C组比较,盆腔缺血性并发症发生率明显增高,差异均具有统计学意义(P=0.012、0.007);B组与C组比较,盆腔缺血性并发症发生率变化不明显,差异无统计学意义(P>0.05)。结论EVAR手术治疗肾下型AAA时,术中封闭双侧髂内动脉较封闭单侧髂内动脉或保留双侧髂内动脉,术后盆腔缺血性发生率明显增加,建议术中尽量保留髂内动脉。
ObjectiveTo explore the effect of occlusion of the internal iliac artery during endovascular aneurysm repair(EVAR)of abdominal aortic aneurysm(AAA)on postoperative pelvic ischemic complications in patients.MethodsA retrospective case-control study was conducted to analyze the clinical data of 177 patients with subrenal AAA who received occlusion of the internal iliac artery during EVAR treatment at Inner Mongolia People′s Hospital from January 2018 to October 2023.They were divided into groups A,B,and C based on the occlusion of the internal iliac artery during surgery.Patients in group A(n=20)involved intraoperative occlusion of bilateral internal iliac artery;patients in group B(n=75)involved intraoperative occlusion of unilateral internal iliac artery;patients in group C(n=82)retained bilateral internal iliac artery during surgery.The incidence of pelvic ischemic complications were recorded and compared in three groups of patients after surgery and during follow-up.The measurement data was expressed as mean±standard deviation(±s),and analysis of variance was used for comparison between the three groups;Chi-square test and their continuous correction method were used for comparison between data groups.ResultsThere was no significant difference in age,gender,tumor diameter,smoking,drinking and complications(hypertension,diabetes,coronary heart disease,cerebral infarction,etc.)among the three groups(P>0.05).Compared with group B and group C,the incidence of pelvic ischemic complications in group A was significantly increased,and the difference was statistically significant(P=0.012,0.007);compared with group C,there was no significant change in the incidence of pelvic ischemic complications in group B,and the difference was not statistically significant(P>0.05).ConclusionsIn the treatment of subrenal AAA with EVAR,the intraoperative bilateral internal iliac artery occlusion is more common than unilateral or bilateral internal iliac artery preservation,and the incidence of postoperative pelvic ischemic complications is significantly increased.It is recommended to preserve the internal iliac artery as much as possible during surgery.
作者
贺彦龙
梁越
He Yanlong;Liang Yue(Department of Vascular Surgery,Inner Mongolia People′s Hospital,Huhhot 010017,China)
出处
《国际外科学杂志》
2024年第7期460-465,共6页
International Journal of Surgery
基金
内蒙古公立医院科研联合基金科技项目(2023GLLH0014)
内蒙古自治区蒙医药协同创新中心科学研究项目(MYYXTYB202108)。
关键词
主动脉瘤
腹
髂动脉
缺血
腔内修复术
Aortic aneurysm,abdominal
Iliac artery
Ischemia
Endovascular aneurysm repair
